RN Licensed Policy Writer

Job Summary

Working remotely from anywhere in the U.S., the full-time RN Licensed Policy Writer will be responsible for the development and implementation of Medicare-based Clinical Coverage Policies, conducting research on CMS guidelines, and collaborating with multidisciplinary teams to ensure accurate billing and policy adherence.

Key responsibilities

• Research CMS coverage guidelines and interpret rules for claims payment
• Collaborate with implementation teams to ensure proper policy execution
• Update policies annually or as needed based on changes in coverage rules

Required qualifications

• Current unrestricted RN licensure in applicable state
• 2+ years of experience with Medicare Policy, Claims, or Claims processing
• Proficient in research of the CMS Medicare Coverage Database and interpretation of CMS transmittals
• 1+ years of Coding experience (e.g., ICD-10, CPT/HCPCS)
• Comprehensive knowledge of medical, surgical, and diagnostic procedures and terminology